Complex Regional Pain Syndrome (CRPS) Treatment: Desensitization

By Melanie E. Swan, OTR/L

People with CRPS may exhibit abnormal sensation throughout all or part of the affected area. This often includes increased sensitivity to stimuli such as touch, pressure, or temperature. Desensitization can be an effective way to treat hypersensitivity, especially when used in combination with other medical and/or therapeutic interventions.

What do you mean “desensitization”?
Desensitization is a treatment technique used to modify how sensitive an area is to particular stimuli. This technique is utilized to decrease, or normalize, the body’s response to particular sensations.

How does desensitization work?
A desensitization program is designed to provide consistent stimulus to the affected area for short periods of time, frequently throughout the day. These small bursts of therapeutic activity shower the brain with sensory input. The brain responds to this demand by acclimating to the sensation, thereby gradually decreasing the body’s pain response to the particular stimuli. In short, your body gets used to it-the stimulus becomes tolerable and no longer elicits the maximal pain response.

What is used to desensitize an area?
Desensitization involves application of “unpleasant” stimuli to the hypersensitive area. These stimuli are things that the body is routinely exposed to and do not elicit a painful response when presented to non-affected areas of the body, thus they are not harmful or damaging. The items used for desensitization vary, depending on what the affected area interprets as painful. Stimuli may consist of different textures/fabrics, light or deep pressure, vibration, heat or cold.

What does a desensitization program consist of?
Desensitization programs progress gradually from stimuli that produce the least painful response to stimuli that produce the most painful response. Once the affected area begins to acclimate to the initial stimulus, the next stimulus is incorporated. For example a desensitization program may progress from a very soft material stimulus (ie, silk) to a rougher material (i.e. wool) or textured fabric (i.e. Velcro). The course of this progression may take several days to several weeks, depending on the level of hypersensitivity.

Will desensitization get rid of my pain?
Desensitization may minimize your body’s painful response to various stimuli; however the affected area may still feel uncomfortable when in contact with particular stimuli. The goal of desensitization is to inhibit or interrupt the body’s interpretation of routine stimuli as painful. It does not assure that these stimuli will become pleasant or enjoyable, but that they will no longer provoke an extreme pain response.

How do I begin a desensitization program?
Speak with your physician or your therapist to determine if this is an appropriate treatment for you. An Occupational Therapist or Physical Therapist can develop a desensitization program that meets your needs.